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Selecting the right respiratory equipment

Presented by Mark Reggers and Travis Allen

When respiratory protective equipment is required as part of a hazard control strategy, it is critical it is selected and used appropriately to ensure the required levels of protection are being achieved for all workers.

In this presentation, recorded at the Healthy Lungs Forum in November 2019, Mark and Travis explain the factors and considerations that need to be evaluated to provide confidence that workers are being protected for the specific task and working environments where these hazards may be present. One of the many key considerations that will be covered in detail is the requirement for close fitting respiratory protective equipment to be fit tested to ensure an adequate seal is achieved.

Note: From 1 July 2020 in Queensland the new national workplace exposure standard for respirable crystalline silica was revised from a time weighted average of 0.1 milligrams per cubic metre (mg/m3) down to 0.05mg/m3. This means that, from 1 July 2020, the reference to the workplace exposure standard for respirable crystalline silica in this presentation should be understood as a reference to the new standard of 0.05mg/m3.

Run time: 45 minutes 13 seconds

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Mark Reggers: So yeah, my name's Mark Reggers. I'm one of those 400 hygienists that Pete Aspinall mentioned before and worked for 3M in our technical team, providing a lot of venues and selection use maintenance around the whole world of PPE. So, yeah. We're going to do a high view overview, 40, 45 minutes or so, looking about respiratory protection.

I know we're talking a lot about silica and asbestos, but the same principles apply with any workplace hazard that we're using a respirator to protect our sensor again. So I don't want to get any of you locked in. This is only asbestos and silica type environments that we're going to be looking at respirators. So this is a nice high level overview.

So hopefully we're all very familiar with this lovely slide here, hierarchy of control. And it's been very, very well highlighted where PPE sits in the hierarchy. We absolutely want to be using higher order controls to control, does a lot more than relying on those behaviours that PPE sits.

But I guess the point I really want to try emphasize starting off here, is around that if we need PPE, we've done our risk assessment, we've done our controls, and this is part of our appropriate control strategy. Then PPE, respiratory protective equipment is no less important than any one of the other controls.

If we need it, we need it to work. I know it seems like a fairly obvious thing, but I know you're experienced in going to different work sites, but sometimes PPE is seen as, "Oh, it's the last line of defence. We'll just pick the respirator out of a catalogue. We've given it to a worker. That's good enough." It's not good enough. And this is what we're going to try and talk today to try and give you some education about going forward, depending on what your work play is and what your role is, what I'm thinking about respirators and where that appropriate use is.

There's something I'd also like to start off with talking about PPE. What is the first P in PPE stand for? Personal. I think sometimes that gets forgotten. We just call it PPE, PPE, PPE. We know what PPE is, but we can't forget that PPE needs to be suitable and right for the person.

We're all different and we're expecting the one style size of respirators fit all of us exactly the same. PPE can sometimes fall in the category, it's a consumable, we've got large numbers of workers. Price has to come into it. So we just want to buy one style and we appreciate that, but we can't get over the fact that it needs to be suitable for the person. This is a personal protective equipment.

But the other thing about that first P, I like to remind workers about, that it relies on the person behaviour for that PPE to do what we needed to do. We could have the best respirator in the world, whatever rated filter, but if that doesn't get put on the worker's face, it's not going to be providing any level of protection as well. So we're relying on that person to do the right thing each and every time. But if we need PPE, a lot of situations we do has a residual risk, control. Or maybe it's our primary control measure, depending on the situation, what it may be. We need to make sure that's going to be working.

So we're talking very briefly about selecting respirators, but I just want to highlight. This is one part of respiratory protection program. So, as a reference, if looking to delve a bit more into the space of your workplace, I’d refer you to Australian standard 1715, and it talks about what's required in a program. We're just talking about selection, which makes up one part of that.

So, part of respiratory protection program, we need a program administrator. Who's doing the assessments? What is the contamination level? It talks about medical assessments, putting a full faced respirator on a worker. That has a physiological load on an individual. So we want to ask those key questions before we give a worker, who may have lung condition or previous things, what impact is that going to have on them as well?

So just to highlight, we're just talking about one part of respiratory protection program that talks about training. And we're going to touch on some of those elements, but that is the place to go to delve a bit more into the detail of those types of things as well.

So, first step about selecting respiratory protective equipment is identifying the hazard. And from a respirator, respiratory protection point of view, we can break it down to three key, I guess, hazard categories that are going to inform us as far as selecting respirators. What type of respirator or filter may be suitable for our situation?

So our first one there, particulates. So particulates is a broad term for dust, fume, mist, fibers. They're all physical things. Now, what you breathe in may have a different health impact of what you breathe in. But from a filtration point of view in the particulate world, they're all classed as particulates.

Now, they may be very, very small and we can't see them, but it's still a physical thing. Then we get our gasses and vapours. Are we doing something that has gasses and vapours or particulates? Are we working in oxygen deficient environment? Now, generally oxygen deficient environments are more commonly associated with confined space environments and displacement of oxygen and whole bunch of stuff like that. But there are key questions that guide us down a certain path when we're looking at the type of filters or type of respiratory equipment that we need to be maybe using based on our situation as well.

So particulate. We're talking a lot about particulate hazards today, be it asbestos and silica. So, you're probably familiar with these particular particulate filter ratings, P1, P2 and P3. So a P1 is for mechanically generated particulates. So when we talk about mechanically generated, grinding, crushing drilling, those types of activities.

Where a P2 is for mechanically and thermally generated particulates. So when you're talking about thermally generated particulates, welding fume, bushfire smoke, furnace smelters. So there's a lot more heat and energy. So generally, the particle size range is going to be on the smaller side of things.

And then P3, for highly toxic type materials and mechanical and thermally generated particulates. Now, I'm sure if you ever thought about how a particulate filter ever works before. I think about it all the time, particularly from where I work. But a particulate filter is not like a size selector. It's not a sieve where everything collects on the top of the material.

You think about it, if you've got your colander and you've got your peas and your carrots, they're bigger than the hole that the water goes through. That's how they're stopping and a particulate filter is not that. So the way that I like to try and explain what a particulate filter is actually like, not crudely but a crude expression, but imagine a bowl of spaghetti. In that you can see from this picture here, if you've got all these random fibers going all different orientation sizes. So this is an example of one layer from one of our P2 reusable respirator filters. Now, there's multiple layers and different orientations.

So you think about capturing, if it was just a size select, it would all catch on the top. And that's going to increase our breathing resistance really quickly and become very uncomfortable very quickly. So, as you can see here, we've got a whole bunch of different sizes of dust and fibers. Now, we're talking about respirable crystalline silica, asbestos, the small stuff that Deborah mentioned this morning. It's the stuff that we can't see, is the stuff that's going to get deepest into our lung. It's going to cause the most amount of potential health effects as well. So we've got three micron, seven micron and four micron. Generally, we can see down to broadly as humans, down to 40 micron-ish, depending on our eyesight of course. But this is the stuff that we can't see.

So have you ever thought about when you actually change your particulate filter. So from a filtration point of view, when there's unacceptable breathing resistance, and I like to show this picture to get people thinking about what's actually happening. So as a particulate filter becomes more clogged up, it actually becomes a better filter. Because if you think about those gaps between the fibers, it actually gets smaller and smaller as there's more dust in through the layers. So as that becomes a better filter, what does it also become? Harder to breathe through as well, but we're not going to lose protection.

So a P1, so at the end of the bonding you'll see a test aerosol size, so under the Australian standard, all of the particle ratings get tested against a 0.3 to 0.6 of a micron in size. That is the test aerosol size to pass the Australian standard, and a P1 needs to be 80% efficient to that particle size, at least 80% efficient. A P2, at least 94% efficient, and P3, greater than 99.5% efficiency as well.

So that's a particulate filter. I think hopefully, I always find it interesting with work is understanding how these things are actually working, and how it's actually doing its job that we're relying on as well. Then we've got our gas and vapor cartridges and filters as well. And you're probably familiar if you've worked in workplaces where you've had these type of cartridges. You maybe have seen these different colours before. So under the Australian standard, 17, 16, it specifies a certain colour and a certain class. So A, AX, B, E, G, K, are the type of gas and vapor that it has been rated to protect against. So you may see filters that have multiple colours, a filter may just have one colour, but that's going to tell you, and this is across all brands that meet the Australian standard labelling requirements. So you should be able to pick up any brand and look at these colours, see these letters and know what it's actually for.

What you may also see is a number next to that. So you may see A1, B1, E1, A2, that refers to the capacity. So there's actually more carbon in a cartridge that's going to give us a longer life. Now a gas and vapor cartridge is very different to how a particulate filter works.

It's all about using activated charcoal, activated carbon. It's all about the surface area. So if you look at this picture here, this is actually a magnified view of a piece of carbon showing it's all about the surface area. So as that gas and vapor goes through, it's actually gets caught and gets held onto the surface area of the cartridge, or in the actual bits of carbon inside of there. But with the gas and vapor cartridge, once that cartridge is full, the contaminant is going to pass straight through it. The breathing resistance doesn't change from the day that you open it up brand new, to a day that it may actually be full. So we're working on a very different capture mechanism as well.

So if you have all got a hazard that is a gas and vapor and you put a particulate filter on, I've got a thing on my face, well obviously, the gas and vapor is going to pass through. So understanding what that hazard is, is the first question that I know I'm going to be asking. If you ring me up to ask for some help and advice about your situation, what is the hazard that you're working with? What is the form that it is actually?

Now, the thing I just want to highlight here as well, is that there's not a gas and vapor cartridge for every gas and vapor you may find in the workplace, depending on what you're doing. Particulates is based on a physical capture mechanisms, but with gas and vapor, there's plenty of things out there that you ring me up or the manufacturers up. At the moment, we don't have charcoal or a reliable way to capture and hold it as well. So that's where we may need to look at an air supplied equipment quite often. Just give me the filter with all the colours, doesn't that capture everything? It captures a wider range of things, but it's not everything that you may come across in the workplace. So understanding what that hazard is, goes a long way to selecting what the appropriate filter is as well.

Now, there's a whole bunch of different type of respirators and how a friend has got to stand out there and outside of Wellins with a whole range of this. And you're probably very familiar with some of these particular products as well. So broadly, they're broken down to a couple of different broad categories.

First one here is about air purifying respirators, and we're talking about negative pressure here. So air purifying, it's using a filter to capture the contaminant, clean the air. So what we're actually breathing through is actually clean air and capture the contaminant.

Negative pressure. As we're working hard with our respirator, the pressure that's being created inside it, because we're breathing, there's a negative pressure being created inside the mask and on the actual seal of the respirator, so we don't have a good seal and a fit and we'll get into that. That's going to increase the likelihood of stuff actually bypassing the filter and getting into the seal. But once again, we're still just using a filter to capture the contaminant.

We have powered air purifying respirators. So purifying, we're still using a filter, same concept. We're using a filter, but powered air, we've got a fan or a motor that's actually sucking the air through the filter for us. So from a physiological work impact point of view, it's obviously going to be much more work for a wearer to be doing all the breathing to draw the air through a negative pressure mask or filter, versus a positive pressure system. The fan is going to be drawing this, so there's less physiological load placed on the wearer of that respirator.

So if you've got a worker, so if we've got both using filters, but if you're expecting someone to work for six, seven hours a day in a negative pressure, that's a much more load on them as a wearer versus maybe a positive pressure, that's going to provide less physiological load from that point of view as well.

Then we have our air supplied equipment. So we're not using filters to actually capture the contaminant. We are breathing in air from an external air source. Now that could be a self-contained breathing apparatus tank, probably used to the firies and emergency services wearing that. If think about them, they're going into a burning building, they don't know what the contaminants are, they don't know what the levels are, so they're bringing their own air with them. If that makes sense.

And the other one there, that can connect to an airline hose that may be hooked up to a compressor that's going through an air panel, providing air to them as well, but it's not using filters. And you think about from, I'll just use silica as an example, obviously we have a lot of focus today talking about silica, any one of those negative, sorry, air purifying filters is going to capture silica. But our selection is more than just selecting the right filter. Getting the right filter is an important part. We can't forget that. We've got to get that right, but there's other things that we need to be considered than just the filter as well.

This next slide here, just highlighting that positive pressure. So when you talk about positive pressure, the fan is blowing a high volume of air into a head top, into a mask, and we're creating a positive pressure in the head top, in that the seal, we talk about these loose fitting head tops, is actually pushing out the seal, preventing contaminants going in, in simplistic terms, but you can see from the picture.

So whether that's a positive pressure coming from a powered air unit, or coming from a supplied air source, still working on that concept of a positive amount of air being in a head top there.

Now the Australian standard classifies respirators in different groups of what we call a protection factor. This is a pretty important concept when we start thinking about the reliability and confidence of what we're selecting. So very simply speaking, a protection factor is the ratio of the concentration outside the mask, what is the ambient environment, versus what is the concentration getting inside the mask. When we're putting on a respirator, it's the same concentration outside the mask as getting inside the mask, is the respirator actually doing anything? I'd say no, because it's the same inside as outside. So we want to select something that has a high confidence of reduction and we'll show on the next slide.

But very simply, just say, we've got 20 furry particles floating outside and we're getting two, that's getting inside our respirator through whatever means that may be. 20 divided by two is giving us a 10 times reduction in exposure. So protection factor of 10, if that makes sense. We're trying to reduce the exposure, ideally underneath exposure standard, which we'll get to as well.

So the Australian Standard classifies these different types of respirators into these different groups, with different assigned protection factors. So it's actually assigning a number based on studies and research what all workers should be able to achieve who are clean shaven, fit tested and trained. I just want to put that proviso out there. We're going to go through a couple of numbers now, but all of that is based on workplaces doing the right thing, in that we've got a wearer who knows how to fit it. They've got a mask that actually has been confirmed, can fit their face and they're clean shaven, so we're getting a good seal around there. We take one of those things out of the equation, the predictability, the reliability of the performance of the respirator goes into a grey area. Does that make sense? As far as you would be getting something, but we're not relying on hopefully we get enough to what we're working with.

So the Australian Standard classifies the disposables and all half face respirators as assigned protection factor of 10. It doesn't matter the brand, anything that is half face is given an assigned protection factor of 10. Now sometimes I get the question, "Well gee, those paper style ones, are you saying they're just as good as the reusable ones?" Now with the reusable, you're more likely to get and maintain a seal across the orinasal section, but where's the weak point as far as both of these respirators? They both seal in the same area. Where's the grooviest, Austin Power's part of our face? Around our nose. What moves the most when we're talking, communicating? Our jaw. So the weak point is actually the sealing part, which is why they're treated the same from assigned protection factor, point of view.

Sometimes you'll hear about an Australian Standard, if you put a P3 filter. So we're talking about greater than 99% efficient filter on a half face mask. Australian says to treat it as the same protection factor as a P2. The reason being is that the weak point is the seal, not the filter, if that makes sense.

So we've got to think about protection factors based on the whole combination of the mask, negative pressure, positive pressure, what level of filter and the Australian standard goes into those details. So a loose fitting head top, with a PAPR or a full face with a P2 particulate filter, has an assigned protection factor of 50. And they showed it early this morning, that in the engineered benchtop, this is the minimum compliance, expected level of respiratory protection in that specific industry. So they're raising the bar as the minimum, we're talking about when we know the situation that it is. So we're setting the bar higher to at least be achieving a 50 times reduction in exposure for your industry in Queensland.

I'm from New South Wales and I'm very confident the other states will follow suit, as far as what the bar that's been set by Queensland, which is fantastic. So it's understanding where you're working, what those requirements are.

As we go up a full face with P3 negative pressure has an assigned protection factor of 100 and a positive pressure, tight fitting mask with supplied air with full face has an assigned protection factor of a hundred plus.

So, but what does it actually mean? That's great. Australian Standard has a table and I use that all the time. But I like to try and visualize and we were talking a little bit about the workplace exposure standard. So I like to use this visual way to try and help explain what those protection factors actually mean.

So we've got our workplace exposure standard, whatever that may be for the contaminant in question. So silica 0.1 milligrams per cubic meter at the moment. We're expecting changes. And we're trying to get a worker's exposure to down underneath that number, as low as reasonably practical, as far down underneath as we actually can. We don't want to just be underneath it as Deborah spoke about this morning. It's not a line for everyone's safe, unsafe. So we've got that variation. We want to be as far underneath that as possible. So let's say we're working in an environment and we've done our exposure monitoring and we're getting results for an eight times the workplace exposure standard.

So what respirator would I need to bring that exposure down underneath that workplace exposure standard line? So this is where you go, "Well, that has an assigned protection factor of 10. So for a clean shaven, fit tested, trained worker, we're going to be base our number off at least a 10 times reduction in exposure to bring us down underneath that workplace exposure standard number, whatever that may be.

And the same concept. So the higher we go over the exposure standard, we need a greater reduction in exposure to bring us down underneath that workplace exposure standard. That makes sense from that point of view? So the higher we go, we need a higher confidence. So let's just say we're 30 times over the exposure standard and we were to wear a half face disposable respirator that has an assigned protection factor of 10, is that 10 times reduction going to get us down underneath that workplace exposure standard? No, we're going to fall short by quite a lot.

So this is where understanding the levels are pretty important to be able to appropriately select a class of respirator, based on their assigned protection factors as well. So the higher we go, as you can see here, the greater the reduction in exposure that we actually need.

So when we look at the actual numbers, if we know what the actual number is, we can easily select. And that helps us in that selection point of view as well. So at the moment, 0.1 milligram per cubic meter and where you're getting inside 0.5 something that's at least a 10 times as a minimum, will bring that exposure down. And the same concept works, whatever the exposure standard is, because it's always that reduction in exposure. The lower the exposure standard, at what point we need to up our respiratory protection will be a lot lower compared to other standards as things change.

But hopefully, that makes sense. Whatever we're wearing, we want confidence that our exposure is going down underneath that workplace exposure standard for whatever the contaminate is that we're working with. So if someone rings me up and goes, "Oh, I'm working with hydrogen sulfide." And I go, "First question. Well, what's your exposure level?" "I don't know." It's pretty hard to confidently recommender as a workplace to go, "Well, what are we selecting? Is that going to be enough?" So it's a very important bit of information that helps guide us with our selection.

Now, if there's nothing else you take from me today, fit, fit, fit, fit, fit, fit, fit, fit, fit, fit, fit, fit. I can talk about an hour for how fantastic particular filters work in gas and vapor. But you know what? That doesn't make a difference if the respirator is not fitting the wearer's face. The contaminant is going to take the path of least resistance, which is going to be around the filter, and that's going to bypass into the breathing and there's still going to be a level of exposure even though a worker may be wearing a respirator.

So there is a whole range of different factors that we need to be aware of. Facial hair, we'll touch a little bit more detail on the next couple of slides, but that has a huge impact and it's a tough one. We'll talk about that. Dental work, rapid weight gain, rapid weight loss, will change the face shape over time as well. The training, the knowledge that people have how to fit. Fitting a respirator is not hard, but there are key things that need to be done to have confidence that they're fitting it correctly. And I see things on LinkedIn and Instagram about respirators and stuff, and they've got the respirator upside down. They've acknowledged there's a hazard, they've acknowledged that they need to get something. They've gone and got something, they've gone and put it on their face. But that last couple of percent, it all sort of comes crashing down very, very quickly. So understanding coming through that training is important.

Makeup, not one that I've personally come across, but the standard talks about makeup. Anything that's going to affect or increase the likelihood of a mask moving around on wearers face, that's going to increase the potential for a seal breakage leak as well. Maybe sunscreen, if you've slapped on a ton of sunscreen and you put your mask on. A lot of the time, you've got to think about a respirator is not a magic bubble. You stick it on your head and all of a sudden you've got this magic force field. They're going to move. A respirator is not a set and forget. You're working, you're working hard. Maybe not working hard, but it's not we'll put it on once and we don't have to think about it again. We need to be conscious of what's happening of our respiratory on our face because it's going to move because you're moving and you're working hard as well.

The design and the style of the PPE you're wearing, that has an impact on the fit. The other really big one is other PPE that's being worn. The most common one I hear about, "This respirator is not very good. My glasses fog up because... This is pretty terrible." Well, ding, ding, ding, ding. If stuff's getting out, stuff's able to get in as well. There's your first clue to say that you're not getting an adequate fit if stuff's actually escaping as well.

Now it's not to say you can't fit a respirator, a pair of safety glasses, ear muffs, and a hard hat on an individual. But how practical is that if you're expecting a worker to wear that for many hours of a day? It's going to get uncomfortable pretty quickly. And what are we all going to do as humans want to do? We're going to take something off or we're going to adjust something to make it bearable enough. But a lot of the time, the respirator is going to be slid down a bit down the face to fit the safety glasses on and we're going to affect our seal as well.

So all these things impact the fit of a respirator. So if we're just picking a respirator just because of, "Oh, it's the right filter," and we're not even thinking about any of this kind of stuff as well, we're only setting ourselves up to fail and exposure is still going to happen.

Now, facial hair. This is a tough one in that I don't like to shave. I don't have to shave that often, but I still don't like to shave as well. But the evidence is so clear in showing that any level of facial hair will significantly reduce the expected level of protection when wearing a tight-fitting respirator.

Now, this slide here, we saw a similar picture earlier today about... That is actually one of my facial hairs, a little side project I did this year. I can thank Gillette for that lovely slice through my facial hair there, but you can actually see the size of the particulates we've shown there. If we can see roughly down to 40 micron, those individual particulates, we're not actually going to see that. That's going to easily bypass facial hair. Quite often, you're doing fit testing, and Travis will talk about fit testing. "Oh, my beard is helping me filter out the dusts." Maybe the big stuff that you can see, but as we've been talking about today, it's the stuff that we can't see that we're actually most concerned about.

And that's not even talking about gases and vapours. Gases and vapours are going to bypass that really easily as well, let alone the particulates. Quite often I show these types of pictures and they go, "Oh, that's great Mark." But has anyone actually looked into this? What kind of stats and studies? I'm a hygienist, I like numbers. Absolutely, there's been studies looking to this. And one of the things I guess, the Australian standard has had clean-shaven requirements the current standard for 10 years, it hasn't changed. So I guess I'm trying to bring up more of the studies that why is a mandatory recommendation to be about clean-shaven from these types of studies?

As you can see here, facial leakage increases from 20 times to 1000 times in the presence of facial hair. These studies were done in the 1980s. This is not new information. But given the situation and we're improving, this stuff is out there. At least a 330 fold drop in protection was experienced by bearded wearers. That's huge. What we're putting on, we need to rely on it that it's actually doing what we need it to do. We could be putting on a respirator and we don't have these things in place, that protection may not be there and it may not be enough and we may not find out until it's way too late, years down the track. We're talking about chronic diseases here that take years in many cases. We need to get this right.

So now I just want to show those two pictures side by side with the actual facial hair and the size of the particulates and the filters and the meeting of the size of the fibers in one of our most manufactured to be similar of a particulate filter. The stuff that's easily bypassing a facial hair is not going to be bypassing a filter. Hence, going back to the weak point is the fit, is the seal. And happy to make these kinds of pictures available for your own workplaces. These are very powerful pictures when you're talking to workers because all they're thinking about is the big dust, not necessarily the dust that they can't see. So we've done this as a training and education tool, so workplaces can continue to promote the message of why it's so important to have those things in place.

And facial hair is hard because it's a moving target. What my facial hair is today is different tomorrow and to the day after, and the day after that. So this is sort of a very rough guide around if you've got workers that have facial hair, depending on your situation and your approach and or what may or may not be suitable. So, obviously, anything that is tight-fitting, facial hair is not going to be a go. Even when we're talking about positive pressure respirators with tight-fitting, that is still a requirement to be clean shaven with positive pressure, tight-fitting masks as well.

Now, the reason we've got two question marks there, beards ain't beards. These positive pressure loose-fitting head tops are relying on that positive pressure being maintained in a head top. If we've got a big bushy beard flowing outside of that seal, that positive pressure is not going to be able to be maintained. And that protection as far as preventing stuff actually getting in the head top is going to now, depends on the beard, depends on the person, depends on all those variables. So as the manufacturer, we need to provide this guidance to not check your brain at the door. We're to think about how these things actually work.

So the idea is that if you've got a beard and longer facial hair, as long as we can tack it up inside to the head top, and it's not flowing out of the seal, that could be okay. But if you're tucking so much up, and your beard's up to your eyes, that's probably not going to be that practical as well, but we can have that facial hair flowing out of those loose-fitting head tops. So there may be situations where, depending on the length of the person's beard, there may be nothing suitable that's for them, because when you think about those principles, we're relying on a protection being achieved of that positive pressure and a loose-fitting head top. Once that is not there, well then, are we relying on that particular setup? I know I'm not, and I don't think you would be either as well.

Travis Allen: Great information. Thanks, Mark. In terms of respiratory protection, I want to talk more about the fit testing side. Mark's given us a good overview of the different respiratory solutions. Now, what I want to talk about is a fit testing to make sure those solutions are correct fitment for respiratory protective equipment. So we talk about fit testing. A lot of people think respiratory fit testing has just come around in the last couple of years. It's not the case. It's actually been around since the 1930s. As you can see, the methodology has changed a lot, but the principles have still stayed the same of checking for the correct seal of a respirator, remembering that all tight-fitting face pieces must be fit tested.

So look around the room. There's multiple different face shapes, multiple different cultural backgrounds. Everyone's got a different makeup. So you look at say, for example, first thing I look at is the bottom of your chin to the bridge of your nose to give a measurement of the type of respirator to fit. So it's a personal thing. A lot of the times when we are doing fit testing, we like to let the individual that's being fit tested know that if they're filing the fit test, it's not them failing the fit test. It's a respirator failing them.

So we'll talk about the different types of respirators available. There's hundreds of different respirators available in the market. You've got disposables as Mark spoke about earlier. You've got flat fold, cup shapes. You've got half mask reusables. You've got full face reusables. You've got different rubber compounds. You got different head harness. You got different filter configurations. So it's up to the person or the company that's undertaken the fit testing find the best fitment for that individual. Now some of these systems can be used as positive pressure, but we would still fit test them under negative pressure.

We often talk about it's not one size fits all, and it's definitely not the case within respiratory selection. There is multiple sizes as well within the reusables. There's small. There's small to medium. There's medium to large. There's large to extra large. So it's not just a matter of driving down the shop, going to grab a respirator off the shelf, assuming it's going to fit.

We talk about the different fit testing options. First of all, we talked about the qualitative. Now, this is often referred to as the bag over the head method. It has its pros and its cons. It's cost-effective. It's portable. It doesn't require power. It doesn't require calibration. It does rely on the individual's feedback so it is sensory. So typically you have a sensitivity solution that you'll spray first of all to check the person can taste it, and then you'll go through the actual protocols testing with the concentrate. Now I have heard some horror stories of this being conducted on-site with lining multiple people up, spraying it around the room, and hoping no one's going to taste it. Now that's not the correct way to do it. There is strict instructions from the manufacturers of these products that need to be followed. So again, stressing the competent person deliver the fit testing.

Then we look at the quantitative. Now there is pros and cons to the quantitative as well. It's more expensive. It does require a calibration. It requires a power source, but it will generate reports. It will generate printed cards. For example, it is very exact in terms of what the fitment is the individual is getting based on a ambient particle counter. So it's a lot more advanced. I want to take you through typically what a quantitative fit test would entail.

So here we go. We've got a gentleman walking in. He's got obvious facial hair so strict, clean-shaven policy for any fit testing, for fit testing a right fitting face piece. Details are recorded, selection of mask is made, and we'll fit that up to a port account and go through the training of the respirator and the type of respirator it is. We don't help them adjust it at all. It's up to them to show competency of fitment. We like to fit test with individual's PPE they might be wearing on-site. It's quite important because that will affect the adjustment. You'll see there he's doing the test fit prior to the fit test. Now we're just running the real time to make sure that's going to be a suitable respirator for the individual.

Now we follow the HSE protocol so there's seven different exercises. Within these exercises, we're trying to simulate as close to the job site we might get. So we're putting him under a little bit of duress with stepping up, trying to, again, simulate more than just sitting at a desk putting on a respirator.

Again, you've got multiple different styles available. So the company may have a preference to a style, but if we're finding that preference isn't suitable, we'll look to find another option. So after the individual's finished, we'll give the certificate and a card, and that is available for them to carry on them for anyone to check at any given time.

Back to Mark. He's a much better public speaker than me.

Mark Reggers: One of the things you got to remember is that with fit testing, it's a moment in time. So a person can pass a fit test today... I'm going to come back to the behaviour. They could pass a fit test, get really good numbers, whatever it may be, but if they don't put it on their face tomorrow, it doesn't matter what their fit was. So fit testing is important part of the respiratory protection program to have confidence that protection is being achieved on the job.

Now, as I said before, fit testing has been part of the Australian standard or the current standard for 10 years, and Travis had the pictures from the 1930s. And I guess I'm starting to talk a bit more about the statistics and the studies behind why it's a mandatory part of all respiratory protection program standards across the globe.

And I'm trying to help explain what this actual little graph here is showing. So we've got this particular line here. So what this particular person, Craig Colton has actually done is gone and gathered the data from 12 workplace protection factor studies, so actual studies that have gone out to the workplace and measured what is the protection the half-face respirator is actually providing. So what is actually happening on the job? So that is looking at 12 different studies.

This plotting line here is from four studies where workers were not fit tested. So we're talking about a half-face respirator here that has an Assigned Protection Factor of 10, which is why we have our workplace protection factor coming across the line here and our percentages down here. So what this is actually saying to us is that 98% of the people who were fit tested achieved the Assigned Protection Factor or above.

So this is the impact that fit testing has, where we've got a worker who knows what to do, they're clean shaven and they know what it feels like to correctly fit a respirator as well. Versus out of this cohort here of workers who were not fit tested, only 55% of the workers achieved the Assigned Protection Factor or above.

So it's not to say that you could randomly pick out a respirator of a catalogue and put it on, it's not to say that you may not. But we're going from close to 50/50, flip a coin, you may achieve what you need to achieve versus to 98% in this. So it just highlights the impact that fit testing has and why it's a mandatory part of all these respiratory protection programs. Flip a coin, hopefully we get enough protection to a much higher confidence level of our own workers doing that. So this is where fit testing has a role. But once again, if they don't it put on their face tomorrow, it doesn't matter what fit test result they actually got, hence, the education and training.

So the competence of the person who's actually conducting the fit test is of critical importance when we look about the reliability of the indication of fit being achieved or not being achieved. And as Travis said, if you don't pass a fit test, that's not a reflection on the person, it just means we need to find a mask that fits you.

I know talking to Carol in the past and hearing about people, they know they need to get a fit test, get a fit test, don't pass the fit test, but then just continue to wear the mask that they didn't pass a fit test on because they've met their tick in the box requirement. So if you don't pass a fit test, that's not the end of the journey, that just means that's just not the mask for you. So that's an important thing to consider.

So the current Australian Standard 1715 doesn't provide any detail about what is the level of knowledge or competence the person is performing this fit test actually requires. It's pretty important. There's a lot of reliability going on the fit test, whether something is an adequate fit. Late 2017, there was an international standard, ISO 16975-3, part of a whole suite of respiratory standards that are being reviewed, that actually has a lot of detail about what is the level of knowledge and competence a fit tester should have.

Now, Travis showed the PortaCount machine there. Just because you know how to use a PortaCount doesn't mean you understand respiratory protection. It doesn't mean you understand what are you looking for when you get a poorly fitting respirator? So one of the things that I'm involved with and Travis is as well, and I know a number of people in this room are part of the AIOH, Australian Institute of Occupational Hygienists, is we're developing a respiratory fit testing training and accreditation scheme to make this information more accessible to industries and workplaces to either they want to do fit testing themselves. That's fine, but whoever's doing it has got to have the right knowledge of what they're doing. If they want to be outsourcing it, we're trying to have an accreditation scheme, so the person you're engaging, there's a level of confidence they know what they're talking about.

It's a little bit of the Wild Wild West at the moment. A lot of fit testing companies are popping up and we need lots of fit testing companies as this awareness becomes more known, but we want confidence that the people we're using, or if it's our own people, they're getting the right education and information to follow the process.

It's very methodical, the protocols on how to do a fit test and why you do things the certain way that they are. So it's one of the things we're trying to work on to make that information more accessible, to make a more informed decision. As the Institute, I know from AOH, we're not recommending one fit test method over another, we're not saying you should engage someone versus doing it yourself, but that information needs to be more accessible, so it's a very important part of relying on that fit test in the role. We talk about 98 to 55% in that particular data set, that's based on the person training and educating the why's, the how's and why to put it on their face.

It's pretty obvious with anything that we talk about safety related, people don't know what they don't know, so we need to give them the right education and knowledge to do the things we need them to do and understand why they need to. So it's no different with talking about a respirator as well. Obviously, I've focused more today on the need of protection, understand the limitations of use is just as important to knowing what it is. I've got a thing on my face, but it's a particulate filter and we're going into a gas and vapor environment. We need to understand the limitations and when these things are not suitable.

Filters, air purifying are not creating oxygen. So if we're in an oxygen-deficient environment, well just using an air-purifying device is not going to... So we need to understand the limitations, how to put it on, getting a good fit. All those things we need to understand.

We're getting close to wrapping it up here, but the question I quite often get, "Well, that's great, Mark, there's an Assigned Protection Factor for that class of respirator, but what are my workers actually getting on the job?"

Now, there are three key things I want you to hopefully take away today. The three things go into giving us confidence that a high protection factor is being achieved. Number one, I know it seems pretty obvious, wear time. You've got to have it on your head. Sorry, on your mouth, and correctly fitted to actually do what we need it to do.

This was a couple of years ago, pre 3M, and I was doing some monitoring, specialist monitoring in a workplace. This is a recycling plant down in Sydney and there was this worker and the requirement to wear disposable respirators. He had two on his head, one on his forehead and one on his neck. So close, so close. But is it doing anything for him? No, it needs to be where it needs to be and correctly fit. If you're only wearing it 75% of the time, well there's still 25% that's going to be a level of an exposure. So that's number one, we're going to be wearing it.

Number two, it needs to be the right mask filter combination, as we spoke about. Particulate gas vapor, positive pressure, negative pressure, whatever that right is for your hazard and level of contaminant, we need that to be right. Now, if that's right and you're not wearing, well it's not going to do anything or if you're wearing it and it's not right, well it's still not going to be doing anything in that particular way as well. So we need to get those two things right. Then we need to add in the fit. Can it fit? Hence the process of fit testing. Is it being worn correctly? How they've put it on in the morning or how a worker puts it on in the morning before morning tea, after morning tea, after lunch time, that changes. So this is actually a moving equation.

What they do in the morning is going to be different to the afternoon. So we want to have all these three things in place that we are confident that our workers are actually achieving the protection that we're expecting them, we've selected, that as required. If it is a control we need it to work. So some of you may have seen this picture before, but I love this picture just to highlight these three elements that we're going to go through. So number one, is he wearing it? Yes. Fantastic. He's one third of the way to achieving appropriate protection. Number two, is it the right filter and mask combination? Now this was in the UK. You can see Scotland on the side there. It was a explosion and dust concern, a bit of asbestos in the background there. So we're going to say, yes, it's the right mask and filter combination. Fantastic, we're two thirds of the way there to achieving protection.

Now, very obviously, hopefully you can see from the picture that you probably couldn't more incorrectly fit a respirator if you tried to, or incorrectly fit a respirator if you tried. But just trying to highlight the point of those three elements. I mean, number he's got it on sideways. That's a good starting point, but there's respirators across the world that go round people's ears. So maybe you've seen those before. Obviously he's got facial hair. That's also not an ideal situation, but you can also see the gap between the mask and his face, as you could park a couple of textas in between the face there. So we've got the first two elements. That's great, but the fit side of things, what is he actually achieving protection wise?

Now I'm not trying to pick on this particular person. I'm assuming that he's been given a piece of equipment, a disposable dust mask, and off you go. Obviously you've just got to fit it. But just because you've watched The Block, doesn't mean you know how to appropriately fit the respirator. There's a lot of things The Block leaves to be desired, but anyway, that's a whole other conversation as well. So think about your workers. Are we just giving him something and expecting him just to know how to do it? It's not hard, but there are key things about the disposable, how we mould it on our nose, where do the straps need to be as well. But if you saw that guy walking down the street from a distance front on, does it look like he's got his respirator on? Has he passed the eye test?

I'd say, yeah. I'm looking at someone at the back of the room, they've got their respirator on, but what are they actually getting? This is where putting these things in place to have the confidence that what we're giving our workers, they know what they're doing and why they're doing it to achieve that respiratory protection. So just using this as an example to try and pull together all these elements as we wrap up here. Now, obviously there's a ton more controls that we would do before going straight to PPE, but it's a nice, good visual picture to have this conversation, ask some of these key questions.

Number one, we're talking about actually what filter would they be needing? Obviously, we can see a lot of dust, but are there gases and vapours in there as well? Maybe, maybe not. But this is the point, we're asking these particular questions. What's the exposure? How many times over the exposure standard are they? Two times? 10 times? 50 times? But that's the question. So what filter do we need? Number one, and what class of respirator gives that appropriate assigned protection factor.

Then we talk about the suitability, comfort. Like anything, if it's not comfortable ... If you've got uncomfortable shoes, what are you going to ... You're going to want to take them off. The same thing goes for PPE. Compatibility with other PPE? What's the facial hair situation? What's the fit? Have they been fit tested? What's the thermal load? They're working hard putting... Not to say a full face respirator with particulate filters is still going to protect you from a filtration point of view but how hot is that going to be for that worker if you're asking him to work for five, six, seven, whatever the time period is, that's going to get hot.

So we want to factor those things in. What's the communication requirements? What are all the things that increase the likelihood of a worker taking that respirator off their face? How do we address that before we stick a person in a situation we come across where they're actually taking off and they're being exposed? At the end of the day, we want to make sure it's going to be worn and we want to make sure how long is it going to be worn? We need it to be worn the whole time that it needs to be worn, whenever that hazard is present, depending on the situation as well.

So just trying to pull those things together. So some of those questions in your workplace, maybe new situations you've come across depending on what you do and how you do it. But some of these key things, rather than just selecting a respirator out of the catalogue, because it's the right filter and it's a particulate.

So summing up here, it's not to say that respiratory protection can't be effective. It can be really effective, but the effectiveness relies on behaviour. This is why it's at the bottom of the hierarchy of control, which we've already spoken about today. We're relying on that worker, the wearer, to do the right thing each and every time, morning, afternoon tea. This is why it's at the bottom. Not to say that it can't be, but we need those right things happening all the time.

If it's needed, it's no less of important of a control than any one of the other controls. It is a control and it's needed. We need it to work. We're going to put that effort into making sure it's going to do the right thing. Obviously, as I highlighted at the start, that we've just spoken with some high level stuff about respiratory protection program, this needs to be part of that overall program. There's a lot more detail into that, that could be another whole hour presentation just on that. But just trying to highlight, we're just talking about selection, but there's many other things in there as well. So that's it from me and Travis.